The complications of cardioembolic stroke: lessons from the VISTA database

Cerebrovasc Dis. 2008;26(1):38-40. doi: 10.1159/000135651. Epub 2008 May 30.

Abstract

Background: Cardioembolic stroke (CES) accounts for 20-30% of ischemic strokes. We attempted to describe the complications of CES.

Methods: We analyzed a cohort of CES patients from the VISTA database who were not given thrombolytics.

Results: 397 patients were included. Recurrent stroke occurred in 2.5% (10/397); stroke progression in 7.8% (31/397); systemic bleeding in 3% (12/397), and hemorrhagic transformation (HT) in 1.5% (6/397). A bimodal temporal distribution was observed for HT. The mortality rate was 103/397 (25.9%) and was associated with stroke progression and recurrence.

Conclusions: HT is common in CES patients and presents in a bimodal distribution. Stroke progression is the most frequent serious complication. Further study is indicated to identify predictors of stroke progression.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebral Hemorrhage / etiology*
  • Cerebral Hemorrhage / mortality
  • Cohort Studies
  • Databases, Factual
  • Disease Progression
  • Embolism / complications*
  • Embolism / etiology
  • Embolism / mortality
  • Female
  • Heart Diseases / complications*
  • Heart Diseases / mortality
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Stroke / complications*
  • Stroke / etiology
  • Stroke / mortality
  • Time Factors